UCLA Professor David Cohen explains how there is zero evidence that antidepressant medications work in the long term and calls out the relationship between big pharma and big politics as a cause for the lack of long term studies. Why is there so much focus on medication as the only solution for depression when many studies show they are not only ineffective, but can also be harmful and dangerous. Why aren't other holistic/natural alternatives explored? Before you begin... Take a moment and breathe. Place your hand over your chest area, near your heart. Breathe slowly into the area for about a minute, focusing on a sense of ease entering your mind and body. Click here to learn why we suggest this. Below is a brief clip from of David Cohen, a professor and Associate Dean for Research and Development of at the Luskin School of Social Work, University of California, Los Angeles (UCLA). His research focuses on psychoactive drugs (prescribed, licit, and illicit) and their desirable and undesirable effects as socio-cultural phenomena “constructed” through language, policy, attitudes, and social interactions. He has conducted research on the side effects of psychiatric medications and on withdrawal. Public and private institutions in the U.S., Canada, and France have funded him to conduct clinical-neuropsychological studies, qualitative investigations, and epidemiological surveys of patients, professionals, and the general population. Click here to listen! He has authored or co-authored over 100 book chapters and articles. Recent co-authored books include Your Drug May be Your Problem (1999/2007), Critical New Perspectives on ADHD (2006), and Mad Science (2013). He held the Fulbright-Tocqueville Chair to France in 2012. In the clip, taken from the Medicating Normal documentary, he explains how antidepressants may provide a very short term mood boost for patients. He also expresses why pharmaceutical companies only conduct short-term studies instead of long term studies for antidepressant medications. A study published in the Journal of Clinical Epidemiology looked at 185 meta-analyses on antidepressant medication and found that one third of them were written by pharmaceutical industry employees and that almost 80 percent of the studies had industry ties. A study published in the British Medical Journal by researchers at the Nordic Cochrane Center in Copenhagen showed that pharmaceutical companies were not disclosing all information regarding the results of their drug trials. Researchers looked at documents from 70 different double-blind, placebo-controlled trials of selective serotonin reuptake inhibitors (SSRI) and serotonin and norepinephrine reuptake inhibitors (SNRI) and found that the full extent of serious harm in clinical study reports went unreported. “We really don’t have good enough evidence that antidepressants are effective and we have increasing evidence that they can be can be harmful. So we need to go into reverse and stop this increasing trend of prescribing them.” – Joanna Moncrieff, a psychiatrist and researcher at University College London (source) These medications don’t seem to be prescribed based on honest evidence when it comes to the cause of these illnesses, as well as what exactly these drugs are doing to our brain and biology. For example, A New England Journal of Medicine review on Major Depression is one of multiple that express these sentiments: ... numerous studies of norepinephrine and serotonin metabolites in plasma, urine, and cerebrospinal fluid as well as postmortem studies of the brains of patients with depression, have yet to identify the purported deficiency reliably. According to Daniel J. Carlat, M.D., Associate Clinical Professor of Psychiatry at Tufts University School of Medicine, “And where there is a scientific vacuum, drug companies are happy to insert a marketing message and call it science. As a result, psychiatry has become a proving ground for outrageous manipulations of science in the service of profit.” (source) A 2002 article in the American Psychological Association journal Prevention and Treatment describes the lack of efficacy for antidepressant drugs. Even if there is a difference between drug and placebo, it is clinically insignificant.
The majority of studies on antidepressants actually found no significant difference between drug and placebo.
The negative results were not published and the researchers had to request access to US FDA documents to review the data. A 2008 meta-analysis in PLoS Med has this to say about the lack of efficacy for antidepressants: “Drug-placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients.
The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.” A 2008 article by prestigious researcher John Ioannidis reviewed the evidence that antidepressants are not effective. “While only half of these trials had formally significant effectiveness, published reports almost ubiquitously claimed significant results. ‘Negative’ trials were either left unpublished or were distorted to present ‘positive’ results.” This article ends with the statement: “Nevertheless, even if one feels a bit depressed by this state of affairs, there is no reason to take antidepressants, they probably won’t work.” A recent report that appeared in the British Medical Journal/Evidence-Based Medicine which concluded antidepressants should not be prescribed because there is no evidence that their benefits outweigh the harms- even for major depression.
The Takeaway: When it comes to issues such as depression, nutritional, holistic and mindful interventions never really see the light of day and are never really discussed or recommended by your everyday psychiatrist. In today’s day and age, self education is a must, and that goes for doctors as well. When it comes to solutions to these issues, one must also considered options outside of the pharmaceutical industry and dive into other resources to seek out interventions that may not be motivated by profit. This is why awareness is key. As more people become aware of this type information they begin to seek out alternatives and make new choices. It would be helpful if more effort and funding was applied to study other interventions that may not provide profit for the pharmaceutical industry. Perhaps this also shows the limitation in basing public well being on a capitalistic economy. Perhaps it’s simply a measure of our societal worldview. Depression may not be a problem with brain structure, chemical flow and neurotransmitters. Instead, the mood of depression we experience comes from other factors that in turn may lead to changes in biology, brain structure, chemical flows etc. Mainstream medicine does not identify this issue, because the issue is not biological and is instead rooted in human experience, trauma, how one perceives the world and much more.
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